Individual provider Active NPI

Melissa Grace Skovorodko, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1932705076
Registry record updated Dec 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
294365 Issued in CA
Practice address
16899 W Bernardo Dr
San Diego, CA 92127-1603
Phone
(858) 521-2265
NPI assigned
Dec 4, 2020
Last updated
Dec 4, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 294365 CA Primary

Addresses

Primary practice location

16899 W Bernardo Dr
San Diego, CA 92127-1603

Mailing address

137 E 6TH Ave
Escondido, CA 92025-4907
Phone (408) 315-8537

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210115000932 CA Practitioner - Physical Therapist in Private Practice 8921411778 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stac Physical Therapy Pfi IncGroup PAC ID 4789069337, 9 clinicians

Practice addresses (Care Compare)

11610 Iberia PL
Suite 100
San Diego, CA 92128-2452
Phone (858) 485-6706

Merit-based Incentive Payment System (MIPS)

Final score
88.67 of 100Reported as group
Quality
81.04
Promoting interoperability
99
Improvement activities
40
Cost
82.04

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Personally Fit Inc Physical Therapist CurrentSince Jan 1, 2026 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Jan 4, 2021 Accepting new patients
Sharp Rees-Stealy Medical Group, Inc CurrentSince Jan 4, 2021 Accepting new patients
Stac Physical Therapy Pfi, Inc Physical Therapist CurrentSince Jan 1, 2026 Accepting new patients

Locations

11610 Iberia Pl
Ste 100
San Diego, CA 92128
Phone (858) 485-6706

16899 W Bernardo Dr
San Diego, CA 92127
Phone (858) 499-2705

2020 Genesee Ave
San Diego, CA 92123
Phone (619) 268-9500

5651 Copley Dr
San Diego, CA 92111
Phone (858) 262-6340

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607040000000",
    "number": "1932705076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 E 6TH AVE",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920254907",
            "telephone_number": "408-315-8537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16899 W BERNARDO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271603",
            "telephone_number": "858-521-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOVORODKO",
        "first_name": "MELISSA",
        "middle_name": "GRACE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-04",
        "last_updated": "2020-12-04",
        "certification_date": "2020-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "294365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.